- Brooker Classification:
- based on an AP radiograph;
- this classification has been criticized because bone which appears to be bridging may actually be located
either anterior or posterior to the hip, and thus does not cause significant loss of ROM;
- class:
- class I: represents islands of bone w/in soft tissues about hip
- class II: inclues bone spurs in pelvis or proximal end of femur leaving at least 1 cm between the opposing bone surfaces;
- class III: represents bone spurs that extend from pelvis or the proximal end of femur, which reduce the space between the opposing bone surfaces to less than 1 cm;
- class IV: indicates radiographic ankylosis of the hip;

- Operative Resection:
- main disadvantage is risk of recurrence heterotopic ossification;
- if hetertopic ossfication has caused the loss of motion, consider allowing process to mature (sharp cortical and trabecular markings) before operative resection;
- some recommend waiting 12 months before operative resection;
- once serial radiographs have shown that the ossification is mature w/ sharp peripheral edges and no indication of expansion, resection is considered;
- bone scans and alkaline phosphatase may not be helpful in predicting maturity of the ossification

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Orthopaedics and the US Military

Text Author

Dr. Wheeless enjoys and performs all types of orthopaedic surgery but is renowned for his expertise in total joint arthroplasty (Hip and Knee replacement) as well as complex joint infections. He founded Orthopaedic Specialists of North Carolina in 2001 and practices at Franklin Regional Medical Center and Duke Raleigh Hospital.